Top

Published in:

01-06-2017 | Editorial

Have biomarkers failed in acute kidney injury? No

Authors: Blaithin A. McMahon, Jay L. Koyner

Published in: Intensive Care Medicine | Issue 6/2017

Excerpt

Over the past decade, large prospective cohort studies have repeatedly shown that novel biomarkers are superior in performance to serum creatinine (SCr) in the early diagnosis and prognosis of acute kidney injury (AKI) with this data being summarized in recent reviews [1, 2]. Several investigations have linked these first-generation serum and urinary biomarkers of AKI [e.g., neutrophil gelatinase-associated lipocalin (NGAL) or tissue inhibitor of metalloproteinases (TIMP)-2 and insulin-like growth factor binding protein 7 (IGFBP7)] with adverse patient outcomes even in the absence of a change in SCr concentrations (biomarker-“positive”/creatinine-“negative” status) [3, 4]. We will delineate the barriers to biomarker development and validation in AKI while highlighting methods to overcome these barriers in an attempt to improve the management of patients with AKI. …

Malhotra R, Siew ED (2017) Biomarkers for the early detection and prognosis of acute kidney injury. Clin J Am Soc Nephrol 12:149–173CrossRefPubMed

McMahon BA, Koyner JL (2016) Risk stratification for acute kidney injury: are biomarkers enough? Adv Chronic Kidney Dis 23:167–178CrossRefPubMed

Nickolas TL, Schmidt-Ott KM, Canetta P, Forster C, Singer E, Sise M, Elger A, Maarouf O, Sola-Del Valle DA, O’Rourke M, Sherman E, Lee P, Geara A, Imus P, Guddati A, Polland A, Rahman W, Elitok S, Malik N, Giglio J, El-Sayegh S, Devarajan P, Hebbar S, Saggi SJ, Hahn B, Kettritz R, Luft FC, Barasch J (2012) Diagnostic and prognostic stratification in the emergency department using urinary biomarkers of nephron damage: a multicenter prospective cohort study. J Am Coll Cardiol 59:246–255CrossRefPubMedPubMedCentral

Ronco C, Kellum JA, Haase M (2012) Subclinical AKI is still AKI. Crit Care 16:313CrossRefPubMedPubMedCentral

Waikar SS, Betensky RA, Emerson SC, Bonventre JV (2012) Imperfect gold standards for kidney injury biomarker evaluation. J Am Soc Nephrol 23:13–21CrossRefPubMedPubMedCentral

Koyner JL, Coca SG, Thiessen-Philbrook H, Patel UD, Shlipak MG, Garg AX, Parikh CR (2015) Urine biomarkers and perioperative acute kidney injury: the impact of preoperative estimated GFR. Am J Kidney Dis 66:1006–1014CrossRefPubMedPubMedCentral

Endre ZH, Pickering JW, Walker RJ, Devarajan P, Edelstein CL, Bonventre JV, Frampton CM, Bennett MR, Ma Q, Sabbisetti VS, Vaidya VS, Walcher AM, Shaw GM, Henderson SJ, Nejat M, Schollum JB, George PM (2011) Improved performance of urinary biomarkers of acute kidney injury in the critically ill by stratification for injury duration and baseline renal function. Kidney Int 79:1119–1130CrossRefPubMed

Pickering JW, Endre ZH (2013) Linking injury to outcome in acute kidney injury: a matter of sensitivity. PLoS One 8:e62691CrossRefPubMedPubMedCentral

Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, Bittleman D, Cruz D, Endre Z, Fitzgerald RL, Forni L, Kane-Gill SL, Hoste E, Koyner J, Liu KD, Macedo E, Mehta R, Murray P, Nadim M, Ostermann M, Palevsky PM, Pannu N, Rosner M, Wald R, Zarbock A, Ronco C, Kellum JA (2017) Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nat Rev Nephrol 13:241–257CrossRefPubMed

10.

Meersch M, Schmidt C, Hoffmeier A, Van Aken H, Wempe C, Gerss J, Zarbock A (2017) Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial. Intensive Care Med. doi:10.1007/s00134-016-4670-3

11.

Basu RK, Wang Y, Wong HR, Chawla LS, Wheeler DS, Goldstein SL (2014) Incorporation of biomarkers with the renal angina index for prediction of severe AKI in critically ill children. Clin J Am Soc Nephrol 9:654–662CrossRefPubMedPubMedCentral

12.

Chawla LS, Davison DL, Brasha-Mitchell E, Koyner JL, Arthur JM, Shaw AD, Tumlin JA, Trevino SA, Kimmel PL, Seneff MG (2013) Development and standardization of a furosemide stress test to predict the severity of acute kidney injury. Crit Care 17:R207CrossRefPubMedPubMedCentral

13.

Koyner JL, Davison DL, Brasha-Mitchell E, Chalikonda DM, Arthur JM, Shaw AD, Tumlin JA, Trevino SA, Bennett MR, Kimmel PL, Seneff MG, Chawla LS (2015) Furosemide stress test and biomarkers for the prediction of AKI severity. J Am Soc Nephrol 26:2023–2031CrossRefPubMedPubMedCentral

14.

Zarbock A, Kellum JA, Schmidt C, Van Aken H, Wempe C, Pavenstadt H, Boanta A, Gerss J, Meersch M (2016) Effect of early vs delayed initiation of renal replacement therapy on mortality in critically Ill patients with acute kidney injury: the ELAIN randomized clinical trial. JAMA 315:2190–2199CrossRefPubMed

15.

Smith OM, Wald R, Adhikari NK, Pope K, Weir MA, Bagshaw SM (2013) Standard versus accelerated initiation of renal replacement therapy in acute kidney injury (STARRT-AKI): study protocol for a randomized controlled trial. Trials 14:320CrossRefPubMedPubMedCentral

Title: Have biomarkers failed in acute kidney injury? No
Authors: Blaithin A. McMahon
Jay L. Koyner
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 6/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-017-4792-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Have biomarkers failed in acute kidney injury? No

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 6/2017

Understanding renal recovery

Relying on objective data: the glass half empty of high-flow nasal cannula in bronchiolitis

Intra-alveolar hemorrhages due to left heart dysfunction and calcified constrictive pericarditis

A nephrologist should be consulted in all cases of acute kidney injury in the ICU: No

Myocardial stunning occurs during intermittent haemodialysis for acute kidney injury

Focus on infection and sepsis 2017